Digoxin

Digoxin, drug used to treat heart problems, such as congestive heart failure and irregular heartbeat. It also helps heart function in patients with pacemakers, an artificial implant in the heart that regulates the heart rate. Digoxin works by increasing the force of heart muscle contractions and by regulating the electrical signal that controls heartbeat. It belongs to a group of drugs known as cardiac glycosides.

Digoxin is available in capsule, tablet, and liquid form. All are taken orally, although one form of the liquid is injected. This drug is usually taken once a day on an empty stomach. It may be taken with food, if necessary, to avoid stomach upset but should not be combined with bran or other high-fiber products.

Dosages of this drug vary widely, ranging from 0.125 to 0.5 mg per day. Some patients start treatment at a high dosage (1 to 1.5 mg) on the first day. Children under age ten may take this drug, which is usually divided into two or more small doses. Its safety for use by pregnant women is not known, and nursing mothers should be aware that it does appear in breast milk.

Patients taking digoxin may be asked to check their pulse rate periodically as a way to help determine the most effective dose. The use of this drug should not be halted abruptly, as it may seriously affect heart function. Digoxin is usually effective after one to two weeks of use, but treatment with it is often prescribed for many months or years.

Possible side effects include diarrhea, nausea, stomach pain, vomiting, blurred vision, headache, skin rash, loss of appetite, or breast development in males. Overdose can be caused by slight increases in dosage. Symptoms of overdose include those listed above as well as a very slow pulse and an irregular heartbeat.

Digoxin may interact adversely with a wide variety of drugs. These include but are not limited to antibiotics, antacids, bronchodilators, diuretics, steroids, thyroid hormones, and blood pressure drugs (including beta blockers and calcium channel blockers). Others include the drugs alprazolam and rifampin.

Because of these many drug interactions, patients taking digoxin should alert caretakers of this fact during emergency treatment or medical or dental procedures.